What Cramps Indicate During Pregnancy and When to Contact a Doctor

Although cramping during pregnancy can be scary, it is a frequent and typically harmless symptom. Learn what cramps indicate during pregnancy, and recognize the difference between typical behavior and abnormalities.

Cramps might be scary during pregnancy, but they are a common symptom throughout all three trimesters. The vast majority of minor abdominal cramps are harmless; they are the uterus’s response to any occurrence. “The uterus is a muscle, and muscles can do nothing except contract,” explains Dr. Holly Puritz, a medical director in Norfolk, Virginia. A contraction feels like a cramp.

This means that its natural response is to contract when the uterus is stimulated, whether by a full bladder, strenuous exercise, or another stimulus. According to Dr. Puritz, the crucial thing is determining whether pregnant cramps are typical or cause for concern. Continue reading for our trimester-by-trimester guide to pregnant cramps.

Cramps Early in Pregnancy

According to Dr. Klauser, most pregnant women will have mild cramping intermittently during the first 16 weeks. Here are several frequent reasons for cramping during the first trimester.

Implantation cramping.

When a fertilized egg burrows into the uterine wall, cramping can be one of the earliest indicators of pregnancy for some women. This is known as implantation cramping, and it can feel like your menstruation is about to begin, according to Dr. Puritz.

Uterine expansion.

In addition, Dr. Klauser says that a pulling sensation in the abdomen may be caused by the rapid expansion of the uterus during the first two trimesters of pregnancy. Your uterus must expand and stretch to accommodate your growing child.

Gastrointestinal problems.

Throughout the first trimester, fluctuating hormone levels may cause increased gas, bloating, and constipation. These gastrointestinal conditions can all induce cramping.

Ectopic pregnancy.

In rare instances, first-trimester cramps may be the result of an ectopic pregnancy. Frequently, ectopic pregnancy is accompanied by unilateral cramping, bleeding, dizziness, or shoulder pain. If you have symptoms of an ectopic pregnancy, contact your doctor immediately.


Miscarriages are most frequently caused by aberrant development (usually caused by chromosomal abnormalities). When blood and tissue leave the uterus, the uterus contracts, causing the cramping associated with miscarriage.

Besides cramps, the most obvious indicator of miscarriage is persistent, copious bleeding. See your physician immediately if you fear a miscarriage.

Cramps during the second trimester of pregnancy

Pregnant women are less likely to feel cramps and other unpleasant pregnancy symptoms during the second trimester. Multiple pregnancies are an exception because the uterus expands more rapidly and reaches third-trimester size in the second trimester. Here are some other causes of cramping in the second trimester of pregnancy.

Painful round ligaments.

Around week 13, the uterus may start to develop and stretch the ligaments supporting it, causing pain. Often, round ligament pain is sudden, and intense, and can feel like pulling or tugging. It can be single-sided or double-sided.

Urinary Tract Infections

Minor urinary tract infections (UTIs) can induce cramping in the second trimester of pregnancy. Additional symptoms include uncomfortable urination, frequent urination, and lower abdomen pain. Call your doctor if you think you have a urinary tract infection.

Uterine fibroids.

Uterine fibroids are an uncommon but more significant cause of cramping. In the second trimester, between 15 and 18 weeks of pregnancy, these benign overgrowths of tissue can begin to break down because there is insufficient blood to continue their growth, and the agony is excruciating.

A woman with a history of uterine fibroids should be looking for pregnancy cramps at this stage because she may require hospitalization to manage the pain until it subsides successfully.

In the third trimester, women may experience cramping.

By the third trimester, your body will be performing so many tasks that cramping may feel like an everyday occurrence. There are numerous causes of cramping at this late stage, including baby kicks, indigestion, “practice” contractions, and even preterm labor. Here are three frequent explanations.

Braxton-Hicks contractions

In the third trimester, it is very normal for pregnant women to suffer cramping, typically in the form of Braxton Hicks contractions. These “false” or practice contractions do not develop into genuine labor, but they can help your body prepare for childbirth.

Although Braxton-Hicks contractions only last between 30 seconds and two minutes, they can typically be alleviated by drinking water, adjusting your position, and sleeping.

Preterm labor.

If third-trimester cramping persists and worsens, you may suffer from preterm labor, which begins before 37 weeks of pregnancy. Contact your prenatal care provider immediately; they may wish to examine you. Changes in vaginal discharge, amniotic fluid leak, and regular contractions are indicators of premature labor.

Additional reasons

Placental abruption and preeclampsia are additional significant causes of cramping in the third trimester (a condition characterized by sudden high blood pressure). Contact your physician if bleeding, severe headaches, shortness of breath, swelling, or changes in your vision accompany your cramps.

When Is Typical Labor Pain Throughout Pregnancy?

Sometimes, cramping during pregnancy is normal. According to specialists, cramping after sex, whether solo or with a partner, is not cause for concern. According to Dr. Puritz, one of the most common reasons for cramping is sexual activity.

During vaginal penetration, whether with the penis, fingers, or a toy, you can come into contact with the cervix, which, when bumped or stimulated, can induce mild cramping. In addition, because semen includes prostaglandins that can stimulate the uterus, you may experience cramping if your partner ejaculates near your cervix during penis-in-vagina sex. Lastly, by no means least, orgasm can cause transient uterine cramping.

Dr. Puritz adds that for most pregnant women, having sex is perfectly safe, and if you get cramping afterward, consider getting off your feet and drinking water.

It is also a positive sign if shifting posture improves or worsens cramps. This typically indicates that your cramps are caused by the expansion of the uterus or its supporting ligaments, which is entirely normal during pregnancy. Dr. Klauser believes that if you feel better after passing gas, the pain is likely due to a gastrointestinal issue rather than the uterus.

When to Seek Medical Attention for Cramps

On the other hand, certain situations suggest that something more dire may be occurring. If you observe any of the following red flags, contact your doctor immediately.

You have at least six contractions per hour.

Six or more contractions per hour may be indicative of preterm labor. Moreover, keep an eye out for symptoms such as changes in vaginal discharge, pelvic discomfort, and dull backaches.

Your cramps are accompanied by vertigo, lightheadedness, or bleeding.

It is especially crucial to contact your doctor or midwife if you have cramping combined with other symptoms such as dizziness, lightheadedness, or vaginal bleeding if you have not yet had an ultrasound to confirm your pregnancy, as this could be an indication of an ectopic pregnancy. A miscarriage or placenta previa, a condition in which the placenta blocks the cervix, can also cause bleeding.

You suffer from chronic cramps.

If you are pregnant with more than one baby (which makes you more likely to go into labor early), have a history of going into labor early or having an ectopic pregnancy, or have been told you have a short cervix, you should call your doctor right away.

You are experiencing severe back or stomach discomfort accompanied by nausea, vomiting, and/or fever.

Back spasms and/or abdominal pain could be indicators of appendicitis, kidney stones, or gallbladder illness.

Your cramps are not getting better over time.

It is also crucial to seek medical attention if the physical position and time adjustments do not reduce the cramping sensation.

You exhibit symptoms of preeclampsia.

Upper-right abdominal pain, headaches, swelling, visual abnormalities, and abrupt weight gain characterize preeclampsia. They typically manifest throughout the third trimester.

How to Alleviate Pregnancy-Related Cramps

Dr. Puritz recommends getting off your feet, relaxing, drinking drinks, and, if necessary, taking acetaminophen (such as Tylenol) for pain relief if your pregnancy cramps are not severe. Do not apply a heating pad to your abdomen since increasing your core temperature during pregnancy, particularly in the first trimester, is harmful. (But, using one on your extremities is acceptable, according to Dr. Puritz.)

Dr. Klauser also recommends warm showers. Stretching and sitting breaks during the day can also be beneficial, especially if you notice that your cramping is greater after prolonged periods of standing.

Most essential, you should always notify your prenatal care provider if you experience odd or persistent cramps. Dr. Puritz always tells his patients, “I enjoy a false alarm.” “I’d rather visit you and report that you’re alright than miss something in which I could have interfered.”

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